CN116887779A

CN116887779A - Positioning arm

Info

Publication number: CN116887779A
Application number: CN202180094705.2A
Authority: CN
Inventors: 迈克尔·沃格勒
Original assignee: Ashley Medical Technology Co
Current assignee: Ashley Medical Technology Co
Priority date: 2020-12-29
Filing date: 2021-12-22
Publication date: 2023-10-13
Also published as: WO2022144273A1; US20240058973A1; DE202020107591U1; JP2024501320A; CA3203557A1; EP4103098A1

Abstract

The application relates to a positioning arm (100) for positioning an instrument, device or tool, wherein the positioning arm (100) comprises at least two arm elements (110, 120) pivotably connected to each other about a pivot (131) by a central joint (130), wherein at least one of the arm elements (110, 120) comprises a further joint (140, 150) at an end opposite the central joint (130), wherein the positioning arm (100) comprises blocking means (132) for blocking and releasing the central joint (130) and the at least one further joint (140, 150), wherein the blocking means (132) are arranged on the central joint (130) and effect blocking and release of the further joint (140, 150) via at least one transmission (111, 112;121, 122) formed on the arm elements (110, 120), and wherein the transmission (111, 112;121, 122) is formed by a pair of jawarms (111, 112;121, 122) which simultaneously also form the arm elements (110, 120).

Description

Positioning arm

Technical Field

The present application relates to a positioning arm for positioning an instrument, in particular a medical instrument. However, the positioning arm according to the present application also allows for accurate positioning of various other instruments, devices or tools. For example, these may include measuring instruments, monitors, microphones, speakers, and lighting devices. Ideally, such a positioning arm is also suitable for securing containers and equipment in a laboratory.

Background

A variety of positioning arms with different requirements for different applications are known from the prior art. Particularly in the case of positioning arms for positioning medical instruments, for example, very high demands are placed on the stability, reliability and operability of the positioning arms. Accordingly, in view of these requirements, many attempts have been made in the prior art to further develop and improve positioning systems.

For example, a positioning arm with a swivel or swivel joint and two arm elements articulated thereto is known from applicant's publication WO2017/144172 A1. In this case, the angle between the two arm elements is configured to be fixed by a ratchet attached to the rotator via a coupling, a switch being provided on the coupling, which locks the angular positions of the arms relative to each other in a desired switch position.

The positioning arm known from WO2017/144172A1 has the advantage that the rotational joint of the positioning arm can be easily locked (i.e. blocked) with relatively little force due to the ratchet. In particular, the ratchet can also be easily operated in a sterile environment, for example under a sterile cover foil. In addition, the ratchet allows a certain minimum torque to be specified, thereby reliably locking the positioning arm.

However, the positioning arm known from WO2017/144172A1 has the disadvantage that the operation still depends on the skill of the user. Thus, if the user does not properly operate the ratchet and the arms are misplaced during surgery, there is still a risk of carryover during use. Furthermore, ergonomics or usability is still not optimal. For example, when positioning the positioning arm, the user must simultaneously hold the instrument at the end of the positioning arm and pay close attention to the surgical field. This simultaneous process is very difficult for the user, especially because a relatively high force must be applied when locking the arm, and the rotational movement when turning the ratchet may be opposite to the movement of the other hand. Faster selection of the procedure is also desirable because the positioning arm must be repositioned multiple times before, during, and after the surgical procedure, i.e., multiple times opening and closing are required.

Another positioning arm is known from US patent US10687915B 2. In this patent, the pressure for locking the joint is transmitted to the joint by means of a piston and/or a connecting rod that can be adjusted hydraulically, pneumatically or mechanically. This requires high closing forces and relatively complex transmission elements.

The well known tri-joint support arm or tri-joint holder is composed of a large number of parts which are usually very delicate and have to withstand very high compression and bending forces. This makes the production cost high and very limited in choice of materials. Hard metal alloys or special hardened steels must be used, especially pressure elements/pressure bars and joints (sometimes with special coatings), because other materials cannot withstand. Thus, in the case of common tri-joint retaining arms or tri-joint retainers, the use of lightweight aluminum or plastic materials (for better handling or for the X-ray beam or magnetic field of an MRI scanner) is always accompanied by loss of locking pressure in the joint and loss of retention force of the arm, and durability is also reduced.

Based on the above prior art, it is an object of the present application to provide a positioning arm which obviates the problems and disadvantages of the systems known in the art and has corresponding advantages with respect to them. In particular, it is an object of the present application to provide a positioning arm which allows an ergonomically advantageous, convenient and quick operation of the positioning arm.

Disclosure of Invention

This object is solved by the subject matter of independent claim 1. Further possible embodiments of the application are particularly pointed out in the dependent claims.

The solution according to the application provides a positioning arm for positioning an instrument or tool, comprising at least two arm elements connected to each other by a central joint so as to be pivotable about a pivot axis. Thereby, at least one of the arm elements comprises a further joint at the end opposite the central joint. The positioning arm further comprises blocking means for blocking and releasing the central joint and the at least one further joint, which blocking means are arranged at the central joint and which blocking and releasing of the further joint is achieved via at least one transmission formed on or by the arm element. With the blocking means arranged at the central joint, actuation takes place in an ergonomically favourable grip area laterally above the patient.

The particularly simple and robust construction of the positioning arm according to the application is characterized in that the transmission is formed by at least one pair of jawarms, and particularly preferably by two pairs of jawarms. The jawarms each comprise a longer lever arm and a shorter clamping arm, the lever arms being connectable by blocking means with their rear ends aligned in the region of the central joint, and the clamping arms forming part of the further joint. This embodiment requires a very low actuation force because the jawarms provide additional leverage between the force application point at the end of the longer lever arm and the force transfer point at the shorter clamping arm in addition to the closing force of the blocking device.

Unlike known articulated arms, which do not work with a filament pressure element inside the arm element requiring additional guides, but with a strong pair of pliers directly forming the arm element, an embodiment according to the application results in an articulated arm with three main joints.

Preferably, the two arm elements each comprise a further joint, and the blocking means are connected to the further joint in each case by means of a transmission.

Positioning arms are particularly useful for reliably (i.e., safely and accurately) positioning or holding medical instruments, tools, or accessories during surgery on a patient. Such reliable positioning of instruments or tools (e.g. needles, hooks, forceps or markers) is of paramount importance, especially in neurosurgical or biological biopsy procedures.

When using a positioning arm to position a medical instrument, for example, one of the arm elements is configured to be connected via a further joint to a fastening device for an operating table. The other arm element can be designed to be correspondingly articulated by means of a further joint to an instrument holder which is particularly advantageously designed as a universal adapter. Instead of fastening means for the operating table, the outer end of one of the arm elements may also be provided with magnetic clamping means for fastening to a metal surface, or with screw-type flange plates for temporary or permanent fastening to a wall or a bracket.

According to a first preferred embodiment, the at least one further joint comprises a rotatable gripping body. The rotatable clamping body is designed as a ball or a swivel sleeve, which is particularly advantageous for the additional mounting of the rotatable ball, thus allowing not only any desired rotation, but in fact any desired pivoting angle.

The simple and sturdy design of several parts, in each case at least two jawarms can be manufactured cheaply as identical parts, and the ease of assembly also enables a safe and effective sterilization of all parts of the positioning arm, whereas known positioning arms comprise a large number of parts with many undercuts, holes, blind holes, adhesives, etc., and are therefore difficult to disassemble during the sterilization process and difficult to access in all areas.

In addition to being simple to manufacture and easy to assemble, the positioning arms according to the application are also characterized in that they are configured to fix quite high payloads with millimeter accuracy very safely while being lightweight. Since the jawarms used are also easily manufactured from plastic, the positioning arms they form can be used directly in MRI applications such as the radiation field of a tube.

The blocking means preferably comprise an actuating element which is movable in the axial direction of the central joint and is connected to the actuating means. In a simpler embodiment, the actuation means may be formed by a rotating handle connected to the screw thread, a clamping handle connected to the eccentric or preferably by a battery-powered motor. Although blocking by means of blocking means is preferably performed electrically, manual blocking or releasing of the joint is also possible. For example, the blocking means may be operated without electrical power by a screw or eccentric. With regard to the design of the transmission formed by the jawarms, an additional mechanical transmission takes place between the force introduction and the force transmission, which can be approximately in the ratio of 1:2 to 1:10. Due to this additional gear ratio, only a relatively low actuation is required at the blocking means. The electrical energy required for operating the blocking device in the case of motor drive is preferably supplied by means of a battery. Thus, wiring is not required, as wiring may be a source of risk in the operating room.

The positioning arm according to the application solves this task in an excellent way. The blocking means can be operated very conveniently, easily and quickly by both manual and electric actuation means. Furthermore, the operation is designed to be at least substantially independent of the available force of the user. Due to the additional transmission by means of the transmission, the positioning arm can always be locked in a sufficiently stable position even with a small amount of force and will not be displaced during operation. Furthermore, a small operating stroke of the blocking means enables a very fast operation. The complete locking of the joints of the positioning arm can be achieved in a few seconds.

Another advantage of purely mechanically or electrically operated blocking means is their compactness. In recent years, great technical development has been made in electric drive. Alternative known pressure systems working with compressed air, hydraulic oil, etc. (see for example US10687915B2 mentioned at the beginning) are costly to manufacture, complex to use and maintain, and, due to the fluids used, pose a risk to the field of aseptic surgery and to the users, which the present application can avoid. In particular in terms of sterility, it is advantageous that the electric drive, i.e. the motor, comprising the associated electronics is now also available in a sterilizable manner, in particular in an autoclave manner. This is especially relevant for applications where it is not possible to use sterile cover foils. Regarding sterilizability, the entire positioning arm according to the application is characterized in that its few parts can be completely disassembled very easily and quickly for cleaning and can also be easily reassembled after sterilization.

In particular, it may be necessary to progressively open the various joints to prevent only one fully open condition from being present, in which all joints of the positioning arm move back and forth in an unstable manner. By suitably coordinating and adjusting the actuation paths of the blocking device, the transmission and the clamping body used in the other joints, it is possible in a simple manner to precisely determine which joint is first fully locked and which joint is last fully locked at the start of the actuation of the blocking device. This sequence can also be subsequently altered when needed by using slightly different diameter clamps in the central joint region or using spacer washers.

The further joint preferably comprises a rotatable gripping body. The first advantageous embodiment provides that the further joint with balls as clamping body is designed as a ball joint. A ball joint refers to a joint having a freely rotatable and pivotable sphere. The transmission formed by the jawarms of the present application is configured to receive the ball directly between their clamping arms, which are preferably grooved with slightly concave depressions on the inside of their ends, and lock the ball in place when the lever arms are pressed together.

According to a further advantageous embodiment, the further joint comprises a rotating sleeve which is rotatably held on the clamping arm of the jawarm by means of, for example, grooves or threads and which is locked when the clamping arm is closed. It is particularly advantageous if a slotted receptacle consisting of a plurality of segments is provided in the swivel sleeve at the end of the clamping arm remote from the ball for the ball joint, so that the swivel sleeve rotation and the pivoting movement of the ball within the swivel sleeve provide an additional degree of freedom when the clamping arm is not locked. When the clamping arms are locked, rotation of the rotating sleeve is simultaneously prevented and the balls are also firmly locked by pressing the segments of the rotating sleeve together.

A further advantageous embodiment provides that the clamping body is connected by means of a tie rod to a connection joint (113; 123) connecting the two jawarms. In this case, the tie rod pulls the clamping body toward the channel seat at the end of the jawarm when the jawarm is locked.

According to an advantageous further development of the application, an electric blocking device comprises an electric motor having an output shaft aligned perpendicularly to the axis of the central joint and connected to the blocking device by means of a bevel gear drive or a worm gear. By such a design, the advantage is a particularly high degree of compactness. The resistive switching means may be arranged on one of the arm elements to save space. Generally, in most applications, only very limited space is available and the best possible access from the surgeon to the surgical field has a high degree of relevance. Such a motor gearbox arrangement, which can also be used in the present application, has been described in the applicant's earlier application DE102020122352.8 filed on 8/26 in 2020, which was filed on 22 in 2021 in 6 as PCT/EP2021/067028, and to that extent its content also forms part of the present disclosure.

All of the above advantages can be particularly well used in a positioning arm for positioning a medical instrument. Instead of simple medical devices and instruments, the positioning arm may also be used to position the micro-robot close to the application area, in which case the further actuation of at least one instrument (e.g. a puncture needle) is preferably performed remotely by a robot that is movable in several degrees of freedom.

Drawings

Further features, advantages and embodiments of the application will become apparent from the following description based on the accompanying drawings. As shown in the figure:

fig. 1 is a perspective view of a positioning arm according to the application, having two arm elements articulated at the center, each arm element being formed by a pair of jawarms, and each arm element comprising another external positioning joint, the gripping body of which is formed by a rotating sleeve and a ball received therein,

fig. 2 is a variant of fig. 1, in which the gripping body of the outer joint is formed by a sphere, and on one of the outer joints on the universal adapter there is arranged a hook-shaped instrument,

fig. 3 is a variation of that shown in fig. 2, with a central capture mechanism in the central joint region,

fig. 4 is a variation of that shown in fig. 2, with two discrete capture mechanisms in the central joint region,

fig. 5 is a variation of fig. 1-4, wherein the blocking means of the central joint may be actuated by a clamping handle connected to the eccentric instead of a rotating handle,

fig. 6 is a variation of that shown in fig. 5, wherein the clamping handle is open,

figure 7 is a longitudinal section through a central joint with a rotary handle and two spring elements designed as belleville springs,

fig. 8 is a variant of fig. 7, with a centrally arranged spring element in the form of a clamping handle and a helical spring,

figure 9 is a perspective view from the central articular side of four jawarms forming two arm members side by side,

figure 10 is a side-by-side jawarm of figure 9 in perspective view from the other articular side,

fig. 11 is a variation of the jawarm shown in fig. 9 and 10, with a separately formed latching element, which can be securely connected to the jawarm,

fig. 12 is a perspective view, from below, of the variant shown in fig. 2, in which the holder of the hooking means is detached from the universal adapter,

figure 13 is an enlarged view of the connection between the universal adapter and the holder shown in figure 12,

figure 14 is an enlarged view of the rotating sleeve shown in figure 1,

figures 15-17 are different holders for different instruments or tools that can be coupled with the engaged universal adapter of figure 15,

fig. 18 is a variation of fig. 1, in which a spring element is arranged in the central joint area, designed as an exemplary torsion bar spring, and resiliently preloads the arm element, one of the jawarms in the central joint area has been removed to show this,

fig. 19 is a variation of fig. 18, with the jawarms fully shown and the sterile sleeve or foil indicated in the universal adapter region,

fig. 20 is a variation of fig. 4, wherein the locking device is motor driven in the central joint region,

fig. 21 is a variation in which links are mounted in the clamp body and connect to the connection joints of the jawarms, one jawarm being omitted,

fig. 22 is a variation of fig. 21, having two jawarms,

figure 23 is a first perspective exploded view of the variant of figure 21,

figure 24 is a second perspective exploded view of the variation of figure 22,

figure 25 is a positioning arm having a magnetic attachment at the outer end of the first arm member,

FIG. 26 is a positioning arm having a flange plate disposed at an outer end of a first arm member, an

Fig. 27 is a variation with shortened jawarms.

Detailed Description

Like elements are generally indicated by the same or similar reference numerals in the drawings.

The positioning arm 100 shown in fig. 1 comprises a first arm element 110 and a second arm element 120, which are connected to each other by a central joint 130. At the end remote from the central joint 130, the first arm element 110 comprises a further joint 140, by means of which the positioning arm 100 can be connected to the fastening device 160.

At the end remote from the central joint 130, the second arm element 120 comprises a further joint 150, by means of which the positioning arm 100 can be connected to the universal adapter 170.

The first arm member 110 is formed by an outer jawarm 111 and an inner jawarm 112 that are connected to each other at a connection joint 113 formed, for example, by bolts 1131. The outer jawarm 111 includes a lever arm 1111 from the central joint 130 and a clamping arm 1112 between the connecting joint 113 and the further joint 140. The inner clamp arm 112 includes a lever arm 1121 from the center joint 130 and a clamp arm 1122 in the direction of the other joint 140 behind the connecting joint 113.

At least one gripper 1113 is formed on the gripper arm 1112, and at least one gripper 1123 is formed on the gripper arm 1122. The interior of the clamp arm 1112 includes a recess 1114 and the interior of the clamp arm 1122 includes a recess 1124. The grippers 1113 of the gripper arms 1112 and 1123 of the gripper arms 1122 enclose a gripper body 141 of the further joint 140, which gripper body 141 is in the form of a swivel sleeve 143 in fig. 1. The rotating sleeve 143 is shown enlarged in fig. 14. The rotating sleeve 143 comprises an annular groove 1431 at a distance from its rear end. The rotating sleeve is divided into four segments 1432 by four slots 1433 evenly distributed in the housing parallel to the axis. The slit 1433 extends beyond the annular groove 1431. The diameter of the front circular opening of the rotating sleeve 143 is such that the ball 142 may be inserted inside the rotating sleeve 143 by slightly expanding the segment 1432. The interior of the rotating sleeve 143 preferably comprises a spherical shape for the ball 142.

Ball 142 is connected to a cylindrical connector 144, which preferably has external threads formed thereon, not shown, and which can be screwed into mating internal threads of fastening device 160, also not shown, of fastening device 160.

The second arm member 120 is formed by an outer jawarm 121 and an inner jawarm 122 that are pivotally connected to one another at a connection joint 123, such as formed by a bolt 1231. The outer clamp arm 121 includes a lever arm 1211 from the central joint 130 and a clamp arm 1212 between the connecting joint 123 and the further joint 150. The inner clamp arm 122 includes a lever arm 1222 from the center joint 130 and a clamp arm 1222 behind the connection joint 123 in the direction of the other joint 150.

At least one gripper 1213 is formed on the gripper arm 1212, and at least one gripper 1223 is formed on the gripper arm 1222. The interior of the clamp arm 1212 includes a recess 1214 and the interior of the clamp arm 1222 includes a recess 1224. The grippers 1213 of the gripper arms 1212 and the grippers 1223 of the gripper arms 1222 enclose a gripper body 151 of the further joint 150, which gripper body 151 is configured in fig. 1 in the form of a rotating sleeve 153. The rotating sleeve 153 is shown enlarged in fig. 14. The rotating sleeve 153 includes an annular groove 1531 at a distance from its rear end. The rotating sleeve 153 is divided into four segments 1532 by four slits 1533 uniformly distributed on the outer wall parallel to the axis. The slit 1533 extends beyond the annular groove 1531. The diameter of the front circular opening of the rotating sleeve 153 is such that the ball 152 may be inserted inside the rotating sleeve 153 by slightly expanding the segment 1532. The interior of the rotating sleeve 153 preferably comprises a spherical shape for the ball 152.

The ball 152 is connected to a cylindrical connector 154 that preferably includes male threads (not shown) that can be screwed into mating female threads (also not shown) of a bracket 171 of the universal adapter 170.

Fig. 9 to 11 show four jawarms 111, 112, 121 and 122 as separate components. As can be seen from the figures, the four jawarms 111, 112, 121 and 122 can be manufactured as identical components to the greatest possible extent, which greatly simplifies manufacturing and inventory. Further, as can be seen in these figures, the jawarm 111 includes a bore 1119 formed as a through bore at its end facing the center knuckle 130. Similarly, jawarm 112 includes aperture 1129, jawarm 121 includes aperture 1219, and jawarm 122 includes aperture 1229.

At least two of the jawarms 111, 112, 121, and 122 include latch elements 1115, 1125, 1215, and 1225. In fig. 9 and 10, latch elements 1115, 1125, 1215, and 1225 are formed directly on jawarms 111, 112, 121, and 122. Latch elements 1115, 1125, 1215, and 1225 include teeth 1116, 1126, 1216, and 1226, respectively.

In an alternative embodiment shown in fig. 11, the latch elements 1115, 1125, 1215 and 1225 provided with teeth 1116, 1126, 1216 and 1226 are designed as separate disc-shaped parts, and each latch element comprises two bolts 115 on the side opposite the teeth, which are configured to securely engage with corresponding positioning holes 114 on the jawarms 111, 112, 121 and 122.

The jawarms 111, 112, 121 and 122 form an offset shape with a laterally extending aperture disposed generally in the center of the offset for forming the connection joints 113 and 123, respectively, by through bolts. In these areas of the transversely extending aperture, rectangular cutouts 1117, 1127, 1217 and 1227 are formed in the four jawarms 111, 112, 121 and 122, which cutouts extend generally to the center of the respective jawarms and permit engagement of the respective pair of jawarms 111 and 112 and 121 and 122 in the assembled condition.

The jawarms 111, 112, 121 and 122 can be inexpensively manufactured as identical parts of a solid design, such as aluminum die cast or plastic injection molded parts.

The central joint 130 forms a pivot axis 131 for the first arm member 110 and the second arm member 120. As best shown in fig. 7, the center or intermediate joint 130 connects the rear end of the first arm member 110 formed by the outer and inner arms 111, 112 and the rear end of the second arm member 120 formed by the outer and inner arms 121, 122 by threaded rods 1322 passing through the holes 1119, 1129, 1219, 1229.

In each case, the outer jaw arm 121 of the second arm member 120, the inner jaw arm 112 of the first arm member 110, the inner jaw arm 122 of the second arm member 120, and the outer jaw arm 111 of the first arm member 110 alternate one above the other from bottom to top. The threaded rod 1322 is connected at its upper end to an operating element which is formed as a rotary handle 1321 or, as shown in fig. 5, 6 and 8, as a clamping handle 1324 provided with an eccentric 1325.

The lower end of the threaded rod 1322 is threaded into the nut 1323 as shown in fig. 7 or directly into the internal threads of the outer clamp arm 121 formed in the region of the bore 1219 as shown in fig. 8.

The threaded rod 1322 forms a blocking device 132 together with the operating element, i.e. the rotary handle 1321, the clamping handle 1324 or the motor 1326 shown in fig. 20, and the internal thread of the anchor or the jawarms 121 in the nut 1323.

The motor 1326 is preferably driven by an energy store provided in the housing, which is preferably integrally formed on the jawarms 111, wherein the operating element 1327 is provided in an ergonomically advantageous manner and, as shown in fig. 20, the housing can also be used as a handle in an ergonomically advantageous manner when guiding the positioning arm 100 to a desired position.

Tightening the operating element 1321, 1324 or 1326 presses the ends of the jawarms 111, 112, 121 and 122 against each other. In the only slightly tightened state, a rotational movement about the pivot axis 131 is still possible. On the other hand, if the operating element 1321, 1324 or 1326 is firmly screwed, the rotational movement of the arm elements 110 and 120 relative to each other is blocked at the center joint 130.

This locking may be enhanced by interlocking teeth 1116, 1126, 1216 and 1226 of latch elements 1115, 1125, 1215 and 1225. There are two variants possible here. As shown in fig. 3, in a first variant, a central engagement of the two latch elements 1126 and 1226 is possible. This embodiment is preferred when it is desired to block the other joints 140 and 150 before blocking the center joint 130.

On the other hand, as shown in fig. 4, 5, 6 and 7, the second variation also allows for discrete engagement at both pairs of latching elements 1115 and 1225 and 1215 and 1125. In this case, the intermediate position of the spacer sleeve 133 is advantageous. This second variant is preferably used if it is necessary to lock the central joint 130 before the other joints 140 and 150 are locked.

By blocking the central joint 130 by means of the blocking means 132, the other joint 140 or 150 is also blocked at the same time or with a slight time delay. When the jaw ends are pressed together at the lever arms 1111, 1121, 1211, and 1221 of the jaw arms 111, 112, 121, and 122, the clamp arms 1112 and 1122 of the first arm member 110 and the clamp arms 1212 and 1222 of the second arm member 120 are simultaneously pressed together. Thereby they enclose the clamping bodies 141 and 151, respectively, which are formed by the balls 142 and 152, respectively, or by the rotating sleeves 143 and 153, respectively, which rotating sleeves 143, 153 are in turn adapted to receive the balls 142, 152, respectively, according to a particularly advantageous variant.

By means of the different diameters of the balls 142 or 152 and/or by means of the different thicknesses of the spacer sleeve 133, it is possible to very precisely set which of the joints 130, 140 and/or 150 locks first and which locks last when the blocking means 132 is actuated. According to an advantageous variant, the joint 140 may first be blocked, for example, after the positioning arm 100 has been pivoted substantially to the desired use position. Upon further tightening of the blocking device 132, then the center joint 130 may block, and, for example, after the instrument 190 disposed on the universal adapter 170 has been rotated or pivoted to the target position, the further joint 150 eventually blocks. The order just described is only an example. Any other order is also possible by adjusting the diameter of ball 142 or 152 and/or rotating sleeve 143 or 153 and/or the thickness of spacer washer 133 accordingly. The timing of the locking of the respective joint 130, 140 or 150 can also be affected by varying the length ratio of the lever arm to the clamp arm on the respective pair of jawarms.

Instead of latch elements 1115, 1125, 1215, and 1225, outer taper 1118 on jaw arm 111 engages inner taper 1228 on jaw arm 122 and outer taper 1218 on jaw arm 121 engages inner taper 1128 on jaw arm 112, which also helps stop device 132 from center joint 130, as shown in FIG. 8.

In order to ensure that the blocking means 132 of the central joint 130 are easily opened when the rotary handle 1321, the clamping handle 1324 or the motor 1326 is opened, it is advantageous if the at least one spring element 134 counteracts the closing force. In fig. 8, a helical compression spring surrounding the threaded rod 1322 is arranged in the central region of the threaded rod 1322 as axial spring element 134 for this purpose. In fig. 7, two spring elements 134 in the form of belleville springs are arranged around the threaded rod 1322 between the gripper arms 111 and 122 and between the gripper arms 112 and 121, respectively, at an axial distance from one another.

As shown in fig. 18 and 19, a further spring element 135 is provided, by means of which the first arm element 110 and the second arm element 120 are spring preloaded in a defined position relative to each other, thereby advantageously additionally facilitating the operation of the positioning arm 100 according to the application. Advantageously, this is an extended position where the first arm member 110 and the second arm member 120 enclose an angle of 180 °. In the illustrated embodiment, the other spring element 135 is formed as a torsion leg spring which surrounds the threaded rod 1322 and whose end is fixed to a stop 1351 on the jawarm 112 or a stop 1352 on the jawarm 122.

As shown in fig. 19, the fastening device 160 is configured to be screwed into a holder, not shown, by a screw 163 connected to a rotating handle 162, which may be fastened to a side rail of an operating table, for example. The locking teeth 164 are configured to also help secure the positioning arm 100 in place.

At the other end on the patient side, particularly preferably a universal adapter 170 is provided adjacent to the second joint 150, which can be connected to the connection 154, for example by screwing into the bracket 171. The universal adapter 170 comprises a shaped body 173, which is particularly preferably designed in the manner of a three-sided prism. The forming body 173 is configured to be securely connected with the receiving portion 181 on the holder 180, whereby the forming body 173 is pressed in a wedge shape against both inclined front sides of the receiving portion 181 when the slider 184 movably mounted on the holder 180 is pressed against it from the rear by the rotating handle 182. The universal adapter 170 may also include a rotation shaft 172 formed by a screw 175 with a rotation handle 174 (fig. 19) disposed on the screw 175. The locking disk 176 on the bracket 171 and the locking disk 177 on the shaped body 173 enable the shaped body 173 to be finely rotated and locked relative to the bracket 171, so that the holder 180 located on the shaped body 173 can be correspondingly finely rotated and locked with the tool 190.

The prisms of the shaped body 173 have no sharp corners and edges. If a sterile cover foil 200 is placed between them (see fig. 19), the foil 200 is not damaged. This ensures that the sterility barrier formed by the cover foil 200 is not destroyed. At the same time, the prism of the shaped body 173 always allows a good and especially safe form fit (with and without the cover foil 200 in between), which ensures that the position of the instrument 190 attached to the universal adapter 170 does not change.

As can be seen in fig. 15-17, the universal adapter 170 is configured for easy and quick connection of various tools and instruments 190. In fig. 15, the tool 190 is formed by a hook 191. In fig. 16, tool holder 186 is provided on holder 180, in the example shown, with needle guide 192 mounted thereon for guiding needle 194. In fig. 17, for example, the holder 180 is provided with a pair of tweezers 195, and the tweezers 195 may be fixed to the holder 180 by pinching. The holder 180 is preferably provided with a further axis of rotation 185 such that the tool 190 can be rotated relative to the tool holder 186 and locked by rotating the handle 187.

The universal adapter 170 itself represents a separate inventive feature in that it can be connected by its form 173 to any holder 180 for any tool 190, 191, 192, 193, 194 and 195. Thus, any of the tools 190, 191, 192, 193, 194, and 195 can be placed arbitrarily and quickly replaced on a plurality of such positioning arms 100 as desired during operation. The positioning arm 100 according to the application is also suitable for attaching a preferably teleoperable robotic system or patient positioning system to the universal adapter 170. The locking of the joints 130, 140, 150 in the locked state is stable such that the entire operating table can be lifted on the universal adapter 170, but the setting position of the joints 130, 140, 150 does not change at all.

As can be seen from fig. 9 to 11, the positioning arm 100 according to the application comprises very few clamp arms 111, 112, 121 and 122, which can be easily disassembled and assembled, so that they can be disassembled in a simple manner for sterilization.

Sterility can also be achieved in a simple manner by pulling the sterile cover foil 200 over the entire positioning arm 100. This is only shown in fig. 19 in the region of the further joint 150. The universal adapter 170 allows the cover 200 to be held between the shaped body 173 and the receiving portion 181 on the holder 180 without damage.

Figures 21-24 show another variation of the jawarm. In this case, the clamping body is formed by a partially hollow sphere 1420. In the hole of the ball 140, one end is provided with a screw thread 1421 and the other end is provided with a slot 1422 disposed to cross each other, and one end of a pull rod 1423 having a ball head 1424 is mounted in the hole of the ball 140. The shaft 1426 of the pull rod 1423 penetrates the slot 1422, and the pull rod 1423 is supported on the connection knuckle 113 or the bolt 1131 forming the connection knuckle through a bearing hole 1425 located on the other end of the pull rod 1423 opposite the ball head 1424.

After the pull rod 1423 is inserted into the bore of the sphere 1420, a connector 1440 having threads 1441 attached to one end is threaded into the threads 1421 of the sphere 1420.

When the jawarms 111 and 112 are pressed together against the recess 1114 of the clamp 1113 at the ends of the jawarms 111, 112 (which recess is flatter in this case), the sphere 1420 is pulled by the pull rod 1423, thereby preventing movement of the sphere 1420. The teeth of the holders 1113 are designed to be shorter in this variant than in the variant described for the first time, wherein the teeth of the holders 1113, 1123, 1213, 1223 engage around the holding bodies 141, 151 or the balls 142, 152 to more than half their diameter.

Fig. 25 shows another fastening option of the positioning arm according to the application, wherein the connection 144 of the joint 140 is connected to a magnetic holder 210, which can be set in an active position or inactive by means of a magnetic switch 212. By means of the magnetic holder 210, the positioning arm can be very easily fixed to the metal surface and released again.

In fig. 26, the connector 144 of the knuckle 140 is connected to a flange plate 220, the flange plate 220 comprising a plurality of holes 222 for attachment to a carrier or wall, for example by screws.

Fig. 27 shows a particularly small embodiment of the positioning arm, in which the jawarms 111, 112, 121 and 122 are very short and compact.

List of reference numerals:

100 positioning arm

110 (first) arm element

111 (outer) jawarms (110)

1111 lever arm (111)

1112 clamp arm (111)

1113. Clamp holder

1114. Recess portion

1115. Latch element

1116. Teeth

1117. Incision

1118 (outer) cone

1119 holes

112 Inner clamp arm (110)

1121 lever arm (112)

1122 clamping arm (112)

1123. Clamp holder

1124. Recess portion

1125. Latch element

1126. Teeth

1127. Incision

1128 (inner) cone

1129 holes

113 joint (111 and 112)

1131. Bolt

114. Positioning hole

115. Bolt

120 (second) arm element

121 (outer) jawarms (120)

1211 lever arm (121)

1212 clamp arm (121)

1213. Clamp holder

1214. Recess portion

1215. Latch element

1216. Teeth

1217. Incision

1218 (outer) cone

1219 hole

122 Inner clamp arm (120)

1221 lever arm (122)

1222 clamping arm (122)

1223. Clamp holder

1224. Recess portion

1225. Latch element

1226. Teeth

1227. Incision

1228 (inner) cone

1229 hole

123 joint (121 and 122)

130 (center) joint

131. Pivot shaft

132. Barrier device

1321. Rotary handle

1322. Threaded rod

1323. Nut

1324. Clamping handle

1325. Eccentric device

1326. Motor with a motor housing

1327. Operating element

133. Spacer washer

134 (axial) spring element

135 spring element (torsion spring)

140 (further) joints

141. Clamping body

142. Ball with ball body

1420 ball (in figures 21-24)

1421 screw (1420 middle)

1422 slot (1420 middle)

1423 pull rod

1424 ball head (at 1423)

1425 bearing hole (located 1423)

1426 shaft (1423)

143. Rotary sleeve

1431. Annular groove

1432. Segment

1433. Slit(s)

144. Connecting piece

1440 connector (in figures 21-24)

1441 thread (1440 upper)

150 (further) joints

151. Clamping body

152. Ball with ball body

153. Rotary sleeve

1531. Annular groove

1532. Segment

1533. Slit(s)

154. Connecting piece

160. Fastening device

162. Rotary handle

163. Screw bolt

164. Locking tooth

170 (Universal) adapter

171. Bracket

172. Rotary shaft

173. Molded body

174. Rotary handle

175. Screw bolt

176 lock disk (171 upper)

177 lock disk (173 upper)

180. Retainer

181. Housing part

182. Rotary handle

183. Screw bolt

184. Sliding piece

185. Axis of rotation

186. Tool holder

187. Rotary handle

190 tool, instrument

191. Hook

192. Needle guide

193. Tool carrier

194. Needle

195 forceps

200 (sterile) cover foil (sleeve)

210. Magnetic retainer

212. Electromagnetic switch

220. Flange plate

222 holes (220 middle)

Claims

1. A positioning arm (100) for positioning an instrument, device or tool,

wherein the positioning arm (100) comprises at least two arm elements (110, 120), the at least two arm elements (110, 120) being pivotably connected to each other about a pivot (131) by a central joint (130),

wherein at least one of the arm elements (110, 120) comprises a further joint (140, 150) at an end opposite the central joint (130),

wherein the positioning arm (100) comprises blocking means (132) for blocking and releasing the central joint (130) and the at least one further joint (140, 150),

wherein the blocking means (132) are arranged at the central joint (130) and effect blocking and releasing of the further joint (140, 150) via at least one transmission means (111, 112;121, 122) formed at the arm element (110, 120), and wherein the transmission means (111, 112;121, 122) are formed by a pair of forceps arms (111, 112;121, 122) which at the same time also form the arm element (110, 120).

2. The positioning arm (100) according to claim 1, wherein both the arm elements (110, 120) each comprise a further joint (140; 150), and wherein the blocking means (132) comprise a respective transmission (111, 112;

121、122)。

3. the positioning arm (100) according to claim 1 or 2, wherein the further joint (140; 150) comprises a rotatable clamping body (141; 151).

4. A positioning arm (100) according to claim 3, wherein the rotatable clamping body (141; 151) is formed as a ball (142; 152) and/or as a rotating sleeve (143; 153).

5. The positioning arm (100) according to any of the preceding claims, wherein the forceps arms (111, 112;121, 122) each comprise a lever arm (1111, 1121;1211, 1221) and a clamping arm (1112, 1122;1212, 1222),

wherein the lever arms (1111, 1121;1211, 1221) are configured to be connected by the blocking device (132) with their rear ends aligned in the region of the central joint (130), and

wherein the clamping arm (1112, 1122;1212, 1222) forms part of the further joint (140, 150).

6. The positioning arm (100) according to any of the preceding claims, wherein the blocking means (132) comprises an actuating element (1322) movable in the axial direction of the central joint (130) and connected to actuating means (1321, 1324, 1326).

7. The positioning arm (100) of claim 6, wherein the actuation means is formed by a rotary handle (1321), a clamping handle (1324) connected to an eccentric (1325), or a motor (1326).

8. The positioning arm (100) according to any of the preceding claims, wherein one (140) of the further joints is provided with fastening means (160) adapted to be attached to an operating table and the other (150) of the further joints is designed for connection to an adapter (170) adapted to attach different instruments, devices or tools (190; 191;192; 193).

9. The positioning arm (100) according to any of the preceding claims, wherein the jawarms (111, 112;121, 122) are configured as identical components.

10. The positioning arm (100) according to any of the preceding claims, wherein the clamp arm (111, 112;121, 122) is made of a light metal, a light metal alloy or a plastic material.

11. The positioning arm (100) according to any of the preceding claims, wherein the blocking means (132) comprises a latch element (1125, 1225) arranged or formed on the transmission means (111, 112;121, 122).

12. The positioning arm (100) according to any one of claims 8 to 11, wherein the adapter (170) comprises at least one shaped body (173) for cooperation with a complementary shaped receptacle (181) of a holder (180) for the tool, device or instrument (190; 191;192; 193).

13. The positioning arm (100) of claim 12, wherein the shaped body (173) is configured to be fixed in the accommodation (181) by a slider (184) provided on the holder (180).

14. The positioning arm (100) according to any of the preceding claims, wherein the blocking means (132) are adapted and arranged for the central joint (130) and the further joint (140;

150 A) delay lock.

15. The positioning arm (100) according to any of the preceding claims, wherein at least one spring element (134) is provided in the region of the central joint (130) against the closing force of the blocking means (132).

16. The positioning arm (100) according to any of the preceding claims, wherein at least one spring element (135) is arranged in the region of the central joint (130), which preloads at least one of the arm elements (110; 120) to a predetermined basic position.

17. The positioning arm (100) according to any one of claims 3 to 16, wherein the clamping body (141; 151) is connected by means of a tie rod to a connection joint (113; 123) connecting the two jawarms (111, 112;121, 122).

18. A positioning arm (100) for positioning an instrument or tool,

wherein the blocking means (132) are arranged at the central joint (130) and effect blocking and release of the further joint (140, 150) via at least one transmission means (111, 112;121, 122) formed at the arm element (110, 120),

wherein one (150) of the further joints is designed to be connected to a universal adapter (170) adapted to fasten different tools (190; 191;192; 193).

19. The positioning arm (100) according to claim 18, wherein the universal adapter (170) comprises at least one shaped body (173) for cooperation with a complementary shaped receptacle (181) of a holder (180) for the tool or instrument (190; 191;192; 193).

20. The positioning arm (100) of claim 19, wherein the shaped body (173) is in the form of a three-sided prism having rounded corners and edges.

21. The positioning arm (100) according to claim 19 or 20, wherein the shaped body (173) and the receiving portion (181) are adapted to non-destructively clamp a sterile foil (200) at least partially surrounding the positioning arm (100) or the tool (190; 191;192; 193).